MasonⅡ型桡骨小头骨折区域和安全区对比分析  

Comparative Analysis of Mason TypeⅡRadial Head Fracture Area and the Safe Zone

作　　者：聂志豪 杨朝晖[2] 聂博渊 Nie Zhihao;Yang Zhaohui;Nie Boyuan(Department of Orthopedics,the Second Clinical Medical College,Shanxi Medical University,Taiyuan 030001,China;Department of Orthopedics,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China;Ambulatory Surgery Department,the Second Clinical Medical College,Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第二临床医学院骨科,山西太原030001 [2]山西医科大学第二医院骨科,山西太原030001 [3]山西医科大学第二医院日间手术部,山西太原030001

出　　处：《实用骨科杂志》2021年第12期1087-1090,1101,共5页Journal of Practical Orthopaedics

摘　　要：目的利用三维重建技术测量MasonⅡ型桡骨小头骨折区域并比较其与桡骨小头安全区的差异。方法选取2015年1月至2018年9月于山西医科大学第二医院确诊的MasonⅡ型桡骨小头骨折40例患者资料,男31例,女9例;年龄18~69岁,平均(38±13)岁。对桡骨骨性结构进行三维重建,将桡骨小头拟合为圆,3名观察者分别测量骨折起始线角度、骨折终止线角度及骨折范围。将桡骨小头拟合圆划分为每个10°的扇形,统计每个10°扇形区域包含多少例骨折,对数据进行分析,并与桡骨小头外侧110°的安全区域进行对比。结果MasonⅡ型桡骨小头骨折常发区为30°~120°,其39%(35°)的区域位于安全区,61%(55°)位于非安全区;不易骨折区为210°~270°,其均位于非安全区。平均区为2°~153°,其42%(63°)的区域位于安全区,58%(88°)位于非安全区。结论MasonⅡ型桡骨小头骨折区域主要位于前外侧和前内侧,而安全区位于前外侧和后外侧,证明桡骨小头骨折常累及非安全区,测量结果为临床医生选择合适的手术入路及内固定方式提供了直观的指导数据。Objective To mesure the fracture area of Mason typeⅡradial head fractures using three-dimensional reconstruction and compare the relationship with the safe zone.Methods We collected forty patients(31 males and 9 females),which aged from 18 to 69 years old,with an average of(38±13)years old.The patients were diagnosed of radial head fractures in the Second hospital of Shanxi Medical University between January 2015 and September 2018.The 3D models of radial head fractures were created.We assumed the articular surface of the radial head to be a circal,and the start angle,end angle and fracture area of the radial head were measured by three separate observers in each case,and the data were statistically analyzed.We divided the fitting circle according to a clock face of 360°,with every interval of 10°considered a sector.The averages of the start angle,end angle,fracture area,and bisector angle of the fracture area of the radial head were calculated,and their relationships with the safe zone(110°)were determined.Results We found 30°to 120°as the common fracture area of Mason typeⅡradial head fractures,with 39%(35°)in the safe zone and 61%(55°)not in the safe zone.No patient had involvement in any sector among the six intervals between 210°and 270°,we considered this area to be the rare fracture area.We regarded the area from^(2)°~153°as the average fracture area of Mason typeⅡradial head fractures.In the average fracture area,42%(63°)was in the safe zone and 58%(88°)was not.Conclusion Mason typeⅡradial head fracture area is mainly located in the anterolateral and anteromedial,while the safe zone is located in the anterolateral and posterolateral.It is proved that the fracture of radial head often involves the unsafe area.It provides intuitive guidance for clinicians to choose suitable therapeutic treatment and internal fixator.

关 键 词：桡骨小头骨折 安全区 计算机断层扫描 三维重建 

分 类 号：R687.3[医药卫生—骨科学]